Conducting the 'Count'

Because procedures conducted at our office do not involve exposure of sterile body compartments, this rule generally does not apply to our practice. If appropriate to the procedure, a surgical count will be performed at the completion of the procedure in order to account for the total number of counted items.  The purpose of conducting the count is to prevent any item from being unintentionally left in the wound and to establish a formal, documented account of counted items used. However, because open surgery involving a sterile field is not performed at our center, this rule is generally not applicable. 
1.  Counted items include:
    A.  4x4 sponges 
    B.  Laparotomy squares with x-ray evident strip
    C.  Knife blades 
    D.  All needles
    E.  All sutures and suture materials
    All additional sponges, needles, lap squares, and blades 
    that are added during a case are handed directly to the 
    surgery technician, and they are added to the count.
2.  A sponge count is reported and recorded with the full
    signature of the clinical staff person conducting the
    count recorded on the operative report.  A written record
    of the sponge count is kept on the operating room
    accounting record. 
3.  If the count is not correct, the surgeon will be
    immediately informed. 
4.  Sponges used within the body cavity have a radio-opaque
 identifier.  An x-ray may be ordered by the surgeon if 
    the post-procedure count does not agree with the original
    count.  Sponges without identifiers should not be used in
    conjunction with identifiers on the same sterile field if 
    sponges require a count.
5.  Once the first count has been taken, nothing shall be
    removed from the room until the final count has been
    taken and is found to be correct.

Approved By Governing Board    
Control #66.0